Comparison of cultured epidermal autografi and massive excision with serial autografting plus homograft overlay

The chief determinant of mortality in severe burn injuries has been the size and severity of the wound. Early massive excision of the wound has increased the median lethal dose to 98% of total body surface area burn but presents the problem of wound closure. Autografi: Substitutes must be used for a large burn. We report our experience with early massive excision in the treatment of 47 pediatrie patients with burns who had >80% total body surface area burn and >80% full-thickness burn. Four patients died within hours of admission. Fifteen patients died of sepsis and multiorgan failure; the primary source of bacterial contamination was the open wound. The 28 survivors received approximately 2.0 m² 2:1 homograft until autografi: Became available. A case report of a 10-year-old boy illustrates the use of two types of cultured epidermal autografi:, one “homegrown” and one commercially produced.